Statement By Dr. William Golden, AHQA Board Member, On the HHS National Health Quality Improvement Initiative

Good morning. I am William E. Golden, a general internist and geriatrician who practices at the University of Arkansas for Medical Sciences and the Director of Quality Improvement activities for a quality improvement organization, the Arkansas Foundation for Medical Care.

I am pleased to be here today on behalf of the American Health Quality Association to support the announcement of a new initiative by the Centers for Medicare and Medicaid Services to provide performance information to patients, their families, and other public stakeholders. Over the last ten years we have learned a lot about measuring quality in health care and how to use that information to improve services to our communities. It is clear that education, good science, and inspired administrative practices can accomplish important changes to improve health care and to control its costs. The public release of selected performance measures will add yet another tool to sustain and expand efforts to make health care in this country achieve new levels of quality and services.

Long-term care has been an area of difficulty for patients, providers, payers, and families. There are many challenges in achieving excellence in nursing home care, which range from personnel, severity of illness, finances, clinical science, and commitment of various participants. Nevertheless, provision of selected performance measures as outlined in today's announcement represents a major event in long-term care and health care in general in this country. These measures will provide benchmarks for practitioners to compare their facility with those in other similar communities throughout the United States. This information can help patients and families select facilities for the care of a particular problem.

The measures can motivate local providers to achieve better outcomes. The performance measures can stimulate analysis and discussion of local barriers to achieving such change, and lead to understanding how best practices in other communities can be adopted. Good performance measures can identify what has worked and elucidate what needs to be done. It will be important in the beginning not to make quick judgments about facilities with difficult numbers but rather to assess their response to this information over time.

Health care in this country has great variation in style, technique, and outcomes. Many successful providers of health care rely on activities not published in the medical literature. Public performance measures as outlined today should foster new dialogue and attention to the best and most feasible implementation of clinical science in the community setting of every American. I look forward to working with CMS in my role with the American Health Quality Association nationally, as well as locally with the Arkansas Foundation for Medical Care, and with the Arkansas Health Care Association, our local professional organization for nursing homes, to encourage understanding and use of this new data on behalf of the American public.